申小勤 孙灿林 宋后恩

[摘要] 目的 探究將瑞芬太尼复合丙泊酚麻醉应用于腹腔镜胆囊切除术患者手术麻醉中的效果。 方法 在该院数据库中方便抽选时间段2016年8月—2018年12月间接受腹腔镜胆囊切除术60例患者纳入该次实验，通过两组均分法将其分为对照组（n=30）与实验组（n=30）。对照组患者采用芬太尼联合丙泊酚进行全身麻醉，实验组患者则采用瑞芬太尼复合丙泊酚麻醉，对两组患者的麻醉状况进行评价，记录所有患者的麻醉后，不良事件发生状况。 结果 实验结果显示，在手术完成后，实验组患者的痛觉恢复时间短于对照组，组间差异有统计学意义（P<0.05）。同时实验组患者的组织时间较对照组明显更短，提示实验组患者的麻醉效果优于对照组，组间差异有统计学意义（P<0.05）。除此之外，实验组患者的不良事件发生率为4例（13.33%），低于对照组患者的9例（30.00%），数据经对比分析，差异有统计学意义（χ2=8.187 0，P<0.05）。 结论 将瑞芬太尼复合丙泊酚麻醉应用于腹腔镜胆囊切除术患者的麻醉中，能够有效改善患者的麻醉效果，有助于缩短阻滞起效时间和患者的术后疼痛恢复时间，同时也有助于降低患者麻醉不良事件的发生率，是一种积极且安全的麻醉方案，值得推广使用。

[关键词] 麻醉;瑞芬太尼;丙泊酚;麻醉方案;预后影响

[中图分类号] R614          [文献标识码] A          [文章编号] 1674-0742（2019）06（c）-0103-03

[Abstract] Objective To investigate the effect of remifentanil combined with propofol anesthesia in surgical anesthesia for patients undergoing laparoscopic cholecystectomy. Methods 60 patients who underwent laparoscopic cholecystectomy between August 2016 and December 2018 in our database were conveniently selected in the experiment. They were divided into two groups by the two groups of equalization methods （n=30） and the experimental group （n=30）. Patients in the control group underwent general anesthesia with fentanyl and propofol. Patients in the experimental group were anesthetized with remifentanil combined with propofol. The anesthesia status of the two groups was evaluated， and adverse events were recorded after anesthesia in all patients. situation. Results The experimental results showed that after the operation was completed， the pain recovery time of the experimental group was shorter than that of the control group， and the difference between the groups was statistically significant （P<0.05）. At the same time， the tissue time of the experimental group was significantly shorter than that of the control group， suggesting that the anesthetic effect of the experimental group was better than that of the control group， and the difference between the groups was statistically significant （P<0.05）. In addition， the incidence of adverse events was 4 cases（13.33%） in the experimental group and 9 cases（30.00%） in the control group. The data were compared and analyzed， and the difference was statistically significant （χ2= 8.187 0，P<0.05）. Conclusion The application of remifentanil combined with propofol in anesthesia in patients undergoing laparoscopic cholecystectomy can effectively improve the anesthetic effect of patients， and help to shorten the onset time and the postoperative pain recovery time of patients. It also helps to reduce the incidence of adverse anesthesia in patients. It is an active and safe anesthesia program that is worth promoting.

[Key words] Anesthesia; Remifentanil; Propofol; Anesthesia program; Prognosis effect

腹腔镜胆囊切除术是一种临床上应用于治疗各种胆囊疾病的重要手术方案[1]。该种手术方案不会对患者造成较大的手术创口患者在术后恢复中的并发症发生率较低，具有较好的治疗效果[2]。同时患者的肢体上不会出现较为明显的瘢痕，具有较高的美观度，在目前临床医学中已经逐渐取代传统开腹手术，在临床上得到了广泛应用[3]。但值得注意的是，该种手术方案需要建立二氧化碳气腹，但手术中如果应用气管插管进行全身麻醉就会对手术效果造成一定的影响，所以为了确保患者的手术麻醉深度足够，并且保持麻醉平稳，就应当对患者进行相应的手术麻醉方案选择，以保证患者的手术效果和术后苏醒[4]。……